Why do I say I'm fine when I'm not? Rachel Mason on asking for help

How are you? I'm fine. It's so automatic that most of us don't hear ourselves saying it. We say it on a good day, on a bad day and on days when something is really, genuinely wrong. I wanted to talk to Rachel Mason about it because she said "I'm fine" through some of the hardest things a person can go through.

Rachel had IVF to have her son. When he was just over one, she noticed bloating that didn't feel right and booked an ultrasound, expecting to be told she had a cyst. Within weeks she had been told it was a tumour, had open stomach surgery and then heard it was stage three borderline ovarian cancer. She was advised to have a full hysterectomy, which meant surgical menopause at 30 and no more children. She has now been in surgical menopause for seven years.

Why do I say I'm fine when I'm not?

Rachel thinks part of it goes back a long way. Women have been called dramatic and hysterical for so long that we learned to push things down rather than be seen that way. She can picture her mum saying "fine" through gritted teeth, and thinks we probably picked it up there.

She also thinks it's practical. Women still carry most of the mental load, often while earning as much as or more than their partners. Saying what's actually going on "opens a whole can of worms that you've then got to deal with." "I'm fine" keeps one more thing off the to-do list.

I think it's self-perpetuating too. We see other women saying they're fine and getting on with it, and we don't want to be the one who steps out of line.

When you're not at the top of your own list

Rachel's only symptom was bloating. She noticed it every time she lay down, for a few weeks, and thought it wasn't quite right. She meant to book a doctor's appointment, but there was a family trip to Thailand for a friend's wedding, and a lot going on. "I wasn't top of the to-do list at all," she said. "I thought, it's okay. I'm fine."

She tries not to dwell on how things might have been different if she'd booked that appointment straight away. But it's a familiar pattern: noticing something, deciding it can wait, and letting everyone else's plans come first. Persistent bloating is one of the symptoms the NHS lists for ovarian cancer. If something about your body has changed and keeps happening, it's worth getting it checked rather than waiting until life is less busy.

Advocating for yourself at the doctor

The first time Rachel realised she could advocate for herself was when her surgeon told her she would need a full hysterectomy. She didn't want that, and she didn't particularly like him. But he was her surgeon, and she assumed that was that.

It wasn't. She asked for a second opinion, paid for a private one and ended up with three opinions. All of them said the same thing: roughly a one in twenty chance of the borderline cancer turning invasive. "If someone said, you've got a one in twenty chance of dying if you do this, you probably wouldn't do that thing," she said. That, and wanting to be around for her son, is what made the decision.

She also fought for her fertility. Around five IVF clinics told her they wouldn't do egg collection. She didn't find anyone who would, but she tried, and that matters to her now. "At least today I can sit here and say, I know that I tried." She thinks a lot of peace comes from knowing you did everything you could.

Asking for that second opinion made her feel bad. "I don't think it's a comfortable place to push back on doctors or anyone that feels superior to you," she said, "even though we're talking about my health and my body." She's glad she did. A different surgeon performed her hysterectomy, she genuinely liked and trusted him, and the whole experience felt different from the surgeries before, when she'd just accepted whoever she was given.

From Rachel's story, advocating for yourself can look like asking for a second opinion, asking whether you can see a different surgeon, and asking questions until you understand the odds you're being given. None of that makes you a difficult patient.

Asking for help without feeling like a burden

"I don't want to be a burden ever," Rachel said. Especially not to anyone she sees as busy or in demand.

After her hysterectomy she was offered therapy, which she says should be standard practice. She went to one session, looked at the posters on the walls and thought, someone needs this more than me. She didn't go back. It was on the NHS, and she felt bad taking it.

That one stopped me. It's the same thought so many of us have: everyone else deserves this more. It's a way of not taking up space or anyone's time, even when the help has been offered specifically for people in your situation.

Why is it hard to accept help?

Rachel was married at the time and didn't know how to ask for the support she needed. On the day of her open stomach surgery, her then-husband went to work up north. She took herself to her hysterectomy on the train. She sat in the waiting room alone and read her book. She's clear she doesn't blame him: "He was not a mind reader, but I also didn't know how to ask for it." She kept saying she was fine.

Years later, with a new partner, she mentioned a routine follow-up CT scan and planned to go alone, as she always had. He said he'd come with her. It made her uncomfortable. She'd done it so many times on her own that it didn't seem like a big deal, and at first she couldn't relax into having him there. Eventually she did. That hour in a hospital waiting room has become a core memory of their relationship, because it was support she now realises she needed all along.

I recognise the discomfort. I'm someone who naturally wants to work everything out myself. Over the last couple of years I've had to learn to say I need support and then step back, like letting my husband handle all the school admin his way. Not being in control doesn't sit well with me. Rachel feels the same, even with her son, when she needs to say, please just give me ten minutes.

We both think there's another side to it too. If you try to control everything, you don't give other people the space to step up.

What to say instead of I'm fine

Rachel's advice to her younger self is simple: think beyond "I'm fine". During major health issues or life changes, you probably aren't fine, and that's okay. Work out what you're actually feeling, stop worrying about being a burden and say what you need. "If you don't just say what you need, no one's gonna know."

And if you don't know what you need? She says it's about small tools that work for you. For her, it's writing things down: a notes app on her phone, a diary before bed. It's also why she started her blog. She noticed a phase of picturing herself pouring a glass of wine whenever she felt sad or stressed, and used that as a signal to stop and ask what was happening.

Her final suggestion is to start your sentence with "I feel". She uses a feelings app that checks in three times a day. It takes work. But "I feel overwhelmed because there's all this going on with school and I've got an important deadline" tells people far more than "I'm fine".

Not feeling so alone

Rachel's Raise community grew almost by accident, from a blog, then TikTok, then a WhatsApp group that got too busy with three hundred people in it. She says the women who join mostly want to feel less alone. She had friends, parents and sisters supporting her and still felt completely alone, because nobody around her understood what she was going through.

Some come in confused and desperate. Others have advocated for themselves, come through it and want to give back. Her goal is to reach the woman sitting in an NHS waiting room who has just heard she's having a hysterectomy at 30, and tell her there are other people going through the same thing. The community's tagline is Together We Shine. You can find Raise at raisecommunity.com.

Listen to the full conversation with Rachel for more on asking for help, emotional wellbeing and women's health, and what changes when you stop saying you're fine.